BRONCHITIS
MEDICINE AND MEDICAL
NURSING
LECTURE BY
C.J SIMUYEMBA
E/N, R/N, BSc Student UNZA
INTRODUCTION
Proper lung function is essential for quality of life, yet there are
many ways this can be disrupted including disease and
infection.
If not monitored and treated these can cause spasms, sputum
retention, inflammation and irritation which all leading to poor
lung function, increased work of breathing and reduced quality
of life.
INTRODUCTION CONT……….
Acute bronchitis is one of the most-common diseases.
About 5% of adults are affected, and about 6% of
children have at least one episode a year.
EPIDEMIOLOGY
Bronchitis is one of the Chronic Obstructive Pulmonary
Diseases (COPD).
COPDs kill around 30,000 people per year in the UK alone and
it is estimated that around 3 million people in the UK have
COPD, 2 million of which are undiagnosed. Chronic Bronchitis
occurs in 3.4 to 22% of the US adult population and rates are
even higher in patients with COPD.
The prevalence of the disease has a great impact on society and
on the health care system around the world.
EPIDEMIOLOGY CONT………….
The primary risk factor for Chronic Bronchitis is smoking, and
up to 25% of long-term smokers will go on to develop COPD.
Other factors are long-term exposure to air pollution, fumes,
and dust from the environment or workplace (Chisholm L.,
D'Autremont K., Abdullzaher E.M., et al., 2015).
OBJECTIVES
General Objective
At the end of this lecture/discussion, students should be able to
acquire knowledge and understanding on acute and chronic
bronchitis.
Specific Objectives
1. At the end of the lecture/discussion students should be able to:
2. Define Bronchitis
3. Outline the causes/ risk factors of Bronchitis
SPECIFIC OBJECTIVES CONT…….
4. Describe the types of bronchitis
5. Explain the pathology of Bronchitis
6. State the signs and symptoms of Bronchitis
7. Discuss the medical management of Bronchitis
8. Outline the complications of Bronchitis
DEFINITIONS
Bronchitis:
It is an inflammation of bronchial tubes (the tubes that
carry air to the lungs and makeup the bronchial tree) (Davis
, 2017).
Bronchitis is an inflammation of the bronchi usually caused
by an infection (Berkow R. et al, 1997).
CAUSES
Microorganisms – viruses and bacteria.
Extension of infection from the trachea
Traumatic injuries
Excessive cold air
Smoking
Over exposure to industrial fumes
Bacteria are less common causes of bronchitis. :
CAUSES CONT………
Bacterial causes include:
o Mycoplasma
Streptococcus
Bordetella
Moraxella
Haemophilus
Chlamydia pneumoniae
CAUSES CONT…………
Viral causes:
Influenza (the same virus that causes colds)
Parainfluenza
Rhinovirus
Adenovirus
Corona viruses
RISK FACTORS
Factors that increase risk of bronchitis include:
Cigarette smoke. People who smoke or who live with a
smoker are at higher risk of both acute bronchitis and
chronic bronchitis.
Low resistance. This may result from another acute
illness, such as a cold, or from a chronic condition that
compromises the immune system. Older adults, infants
and young children have greater vulnerability to
infection.
RISK FACTORS CONT……..
Exposure to irritants in work places. The risk of
developing bronchitis is greater if one works around
certain lung irritants, such as grains or textiles, or are
exposed to chemical fumes.
Gastric reflux. Repeated bouts of severe heartburn can
irritate the throat and predispose to developing bronchitis.
TYPES OF BRONCHITIS
Acutebronchitis- lasts a few days to weeks.
Chronic bronchitis- lasts for at least 3 months to 2 years.
ACUTE BRONCHITIS
Acute bronchitis is the inflammation of the mucosa lining
of the bronchial tree often following infections of the
upper respiratory tract and lasts a few days or weeks
(Brunner and saddarth 2000).
CAUSES OF ACUTE BRONCHITIS
o Influenza (the same virus that causes colds)
Parainfluenza
Upper respiratory tract infections
Rhinovirus
Adenovirus
Corona viruses
Mycoplasma
Streptococcus
Bordetella
Moraxella
Haemophilus
Chlamydia pneumoniae
SIGNS AND SYMPTOMS OF ACUTE
BRONCHITIS
Cough with mucus,
Chest discomfort
Soreness in the throat
Fever
Shortness of breath.
Children may also have:
Runny nose
Mild fever
CHRONIC BRONCHITIS
Defined clinically as a productive cough for at least 3
consecutive months for at least 2 consecutive years.
Chronic bronchitis is a type of
chronic obstructive pulmonary disease (COPD), is
defined by a productive cough that lasts greater than three
months each year for at least two years in the absence of
other underlying disease.
CAUSES
Cigarettesmoking
Exposure to air pollutants such as sulfur dioxide, nitrogen
dioxide.
Recurrent acute bronchitis.
PATHOLOGY OF CHRONIC BRONCHITIS
Chronic bronchitis results in hypertrophy and hyperplasia
of the bronchial mucous glands following the exposure.
This leads to increased mucus production, ciliary damage,
squamous metaplasia of the columnar epithelium, and
chronic leukocytic and lymphocytic infiltration of
bronchial walls.
Hyper secretion from the goblet cells blocks the free
movement of cilia, which normally sweep dust irritants
and mucus from the airway.
PATHOLOGY OF CHRONIC BRONCHITIS
This results in the disappearance of cilia and consequently alters the
function of the alveolar macrophages, leading to increased
bronchial infections.
As a result, the airway stays blocked, and mucus and debris
accumulate in the respiratory tract thus narrowing the airway lumen
leading to diminished airflow. Greater resistance to airflow
increases the work of breathing.
The epithelial layer becomes ulcerated and when the ulcer heals the
walls thicken leading to further narrowing of the airways (Stanley,
loeb, etal, 1992).
SIGNS AND SYMPTOMS OF CHRONIC BRONCHITIS
Fever- this is related to the reaction of the body to the
presence of the pathogenic organism which also increases the
basal metabolic rate with more heat production leading to
raised temperature.
Dyspnoea- this occurs following the inflammatory reactions
and excessive mucus production which results in obstruction
of air flow through the respiratory tract.
Wheezing – this occurs as air passes through an obstructed
airway producing a wheezy sound.
SIGNS AND SYMPTOMS OF CHRONIC
BRONCHITIS
Cough- this occurs due to irritations in the respiratory tract by
inflammatory reactions.
Haemoptysis- this is coughing of blood following the rupture
of capillaries following continuous vigorous coughing and
sneezing reflexes in an attempt to expectorate the irritant.
Chest pains- this occurs in an attempt for the inflamed alveoli
to expand and accommodate air entry.
Cyanosis- this is the blueish discoloration of the mucus
membrane and body peripherals due to reduced oxygen supply
as a result of obstruction in the air way .
DIAGNOSIS OF BRONCHITIS
History taking- about the symptoms and in particular the
cough. They may also ask about the patient's medical
history, whether they have recently suffered from a cold
or flu, whether they smoke, or whether they have been
exposed to substances such as dust, fumes, vapors, or air
pollution.
Physical examination- use a stethoscope to listen for any
abnormal sounds in the lungs.
DIAGNOSIS OF BRONCHITIS……CONT
Throat swab- for microscopy, culture and
sensitivity to isolate the causative organism and
antibiotic it is sensitive to.
Chest x-ray- shows hyper infiltration and
increased Broncho vascularity.
Sputum culture- this may reveal many
microorganisms and neutrophils.
DIAGNOSIS OF BRONCHITIS
Arterial blood gas analysis- this is done which will
display a reduced PaO2 and normal or increased
PaCO2.
Pulmonary function tests- this will demonstrate
increased residue volume, reduced vital capacity and
forced expiratory flow and normal static compliance
and diffusing capacity.
Full blood count- this will show elevated WBCs and
ESR as a sign of presence of infection.
TREATMENT
Supportive treatment:
Bed rest and supportive care such as reducing
coughing are the main treatments for acute
bronchitis.
Stay well hydrated by drinking fluids
Use a humidifier to moisten the air.
Avoid dairy products because they thicken
mucous secretions
TREATMENT CONT……….
Avoid alcohol and caffeine because of potential
drug interactions
Avoid exposure to environmental smoke and other air
pollutants.
Drugs:
Cough suppressants such as Mucolytics (Mucinex,
Mucomyst): These medicines help remove sticky mucus from
the airways.
TREATMENT CONT……….
Acetaminophen and NSAIDs: Nonsteroidal anti-
inflammatory drugs (NSAIDs) and/or acetaminophen (Tylenol
and others) may reduce inflammation and/or discomfort.
Inhaler bronchodilators (Ventolin 4mg 8 hourly for 5
days): This medicine opens airways, which makes it easier to
breathe.
Antibiotics (amoxicillin 500mg 8 hourly for 5 days): Acute
bronchitis is treated with antibiotics only if the cause is
bacterial (suspected or diagnosed).
Oxygen therapy in severe cases, 5-6 liters per minute.
NURSING MANAGEMENT
Nursing Priorities
1. Maintain airway patency.
2. Assist with measures to facilitate gas exchange.
3. Enhance food/ fluid intake.
4. Prevent complications and slow progression of
condition.
5. Provide information about disease process, prognosis,
and treatment regimen.
6. Prevent environmental irritants both
7. Ensure the room is warm
COMPLICATION OF BRONCHITIS
Broncho pneumonia
Corpulmonale
Acute respiratory failure
Pneumonia
Atelectasis
Bronchiectasis
Right sided heart failure
SUMMARY
Bronchitis can be caused by viruses, bacteria, and other
particles that irritate the bronchial tubes.
Acute bronchitis is a short term illness that often follows a
cold or viral infection.
Chronic bronchitis is a long-term illness and can be the result
of environmental factors or extended illness.
Cigarette smoking is the most common cause of chronic
bronchitis.
ASSIGNMENT
Readand write five (5) preventive measures on
bronchitis. To be verified during the next lecture.
REFERENCES
Drake RL, Vogl AW, Mitchell AW, (2010), Gray's Anatomy for
Students. 2nd ed. Edinburgh: Churchill Livingstone.
Charles Patrick Davis, (2017), medicine [Link], accessed
from
[Link]
at_are_the_possible_complications_of_acute_bronchitis
, on 05/ 06/ 2018 at 09:00 hours.
McIntosh J., (2017), medical news today, accessed from,
[Link] on
05/06/ 2018 at 10:00 hours.
(Chisholm L., D'Autremont K., Abdullzaher E.M., et al., 2015),
Physiopedia, accessed from
[Link]
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